Hospitals hype robot surgery for women: study

NEW YORK (Reuters Health) - Consumers shouldn't expect straight talk about robot surgery from hospital websites, but rather vague claims and marketing mantras, according to a new U.S. study.

Researchers sifted through online information from 432 hospitals across the country and found nearly half marketed robotic surgery for gynecologic conditions such as endometriosis or cervical cancer.

A quarter of those hospitals used boilerplate copy from the robot manufacturer Intuitive Surgical, and one in six told consumers that "you owe it to yourself."

However, almost none mentioned potential downsides to the technology such as increased operating time or higher cost compared with conventional types of surgery.

"This is marketing," said Dr. Jason Wright, a gynecologic surgeon at Columbia University in New York, who led the new work. "Many of the claims that were made by hospitals were not supported by high-quality data."

Robot surgery originally took off as a new way to operate on men with prostate cancer, but doctors have since started using it for several other procedures, too. Today, the technology is being used in hundreds of thousands of surgeries every year.

According to California-based Intuitive Surgical, more than 2,200 of its da Vinci robots have been installed worldwide. The machines, which are operated by a surgeon, run between $1 million and $2.5 million each.

Compared with open surgery, in which the doctor makes one long incision, robot surgery leads to a faster recovery and less blood loss, said Wright. But it's not clear that it has any advantages over traditional minimally invasive surgery, called laparoscopy, he added.

"There is definitely a role for robotic surgery and I think it is an exciting technology," said Wright, who uses the technology himself. "But right now the data are really very limited."

WHAT RISKS?

Wright's team found that most hospitals described robot surgery as having several benefits, but just 15 percent referenced data from clinical trials to support those claims.

And only a few hospitals discussed the risks, operating time and price, which is usually at least $1,000 higher than for traditional laparoscopy.

The findings, published in the American Journal of Obstetrics & Gynecology, jibe with a report from last year that looked at how U.S. hospitals describe robot surgery in general on their websites.

That study, in the Journal for Healthcare Quality, concluded that online materials "overestimate benefits, largely ignore risks and are strongly influenced by the manufacturer."

In a quick Web search, Reuters Health found several hospitals advertising "better clinical outcomes" with robot surgery. Yet none of them made clear what those outcomes were or what treatment the comparison group got.

The Nebraska Medical Center in Omaha is a case in point. From its homepage, it takes just two clicks to get to a video touting robotic surgery for gynecologic cancer.

Four minutes later, without having mentioned any risks, she ends the piece by saying, "It's really wonderful to be able to give this option to patients, because it's just plain better."

Rodabaugh did not return phone calls requesting comments; nor did the marketing directors of two other hospitals, St. Anthony's Medical Center in St. Louis and the University of Missouri Health Care in Columbia, both of which advertise robot surgery on their websites.

Wright acknowledged that many hospitals are businesses and have the right to market their services. But at the same time, patients trust hospitals to provide more-balanced information than manufacturers, he said.

"Most patients have a higher expectation of physicians and hospitals," Wright told Reuters Health. "Hospitals should have a mandate to supply unbiased information to patients."

In the meantime, he added, people should quiz their doctor about the risks and benefits of the procedure they are considering and ask about the scientific evidence for those claims.